WinSanTor Neuropathy Survey Question Title * 1. What type of peripheral neuropathy do you have? OK Question Title * 2. How did you get your peripheral neuropathy? OK Question Title * 3. When were you diagnosed with peripheral neuropathy? OK Question Title * 4. How long have you had peripheral neuropathy? OK Question Title * 5. How long have you had your symptoms prior to diagnosis? OK Question Title * 6. What neuropathy symptoms do you suffer from and how often? Please be specific: OK Question Title * 7. Where on your body do you experience symptoms? OK Question Title * 8. What exacerbates your symptoms? OK Question Title * 9. Are you experiencing pain? OK Question Title * 10. Are you on any medications? If so, please list them below. OK Question Title * 11. Are you using alternative or non-drug strategies to cope with peripheral neuropathy? OK Question Title * 12. Who is/are the physician(s) you see for your neuropathy? OK Question Title * 13. Would you recommend the physician you see to other neuropathy patients? OK Question Title * 14. Are you interested in being contacted by WinSanTor to set up an interview? Yes No If Yes, please provide contact information: OK Question Title * 15. Is there anything else you would like us to know? OK Question Title * 16. I have read the WinSanTor Privacy Policy. Yes No OK Question Title * 17. I understand that information I submit through this survey will be used by WinSanTor and participating clinical research sites to provide news, marketing and updates that may be of interest to me. Yes No OK Question Title * 18. I consent to receive communications from WinSanTor and participating clinical research sites. Email Phone Mail OK DONE